• Title/Summary/Keyword: acute rejection

Search Result 82, Processing Time 0.03 seconds

Effect of Parental Bring-up Attitude on Child Abuse Awareness among College Students (부모의 양육태도가 대학생의 아동학대 인식에 미치는 영향)

  • Park, Mijeong;Oh, Doonam
    • The Journal of the Korea Contents Association
    • /
    • v.19 no.10
    • /
    • pp.452-462
    • /
    • 2019
  • This study is a descriptive survey research to investigate the effect of parental bring-up attitude on child abuse awareness among college students. Data were collected using structured questionnaires about parental acceptance-rejection questionnaire, child abuse awareness and child abuse knowledge tool from 272 students attending one university located in A city from April 16 to 30, 2019, and were analyzed using t-test, One-way ANOVA, Kruskal-Wallis test, $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, multiple regression. The results of the study are as follows. First, child abuse awareness of the subjects were found that there was a significant difference according to gender, grade, number of siblings, level of knowledge about child abuse. Second, parental indifference/neglect attitude showed a negative correlation with child abuse awareness. Third, in relation to child abuse awareness, the explanatory power of gender, grade, number of siblings, knowledge level about child abuse, and parental bring-up attitude was 14.3%, and grade, number of siblings, knowledge level about child abuse, and parental indifference/neglect attitude were significant factors. The results of this study can be used as a major intervention strategy in the development of programs to improve child abuse awareness for college students through systematic and practical understanding.

Severe Anemia Due to Parvovirus Infection Following Treatment with Rituximab in a Pediatric Kidney Transplant Recipient : Anemia after Treatment of Rituximab in Kidney Recipient Patient

  • Kim, Seung Yun;Lee, Hyoung Jin;Park, Eujin;Ahn, Yo Han;Ha, Il-Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Childhood Kidney Diseases
    • /
    • v.19 no.2
    • /
    • pp.176-179
    • /
    • 2015
  • Rituximab (RTX), a monoclonal antibody against the B-cell marker CD20, is commonly used as a treatment for antibody-mediated diseases or B-lymphocyte-mediated diseases. Destruction of B cells may reverse the disease course in many conditions; however, patients who are treated with RTX cannot respond appropriately to de novo infection due to lack of B lymphocytes. Here, we report one such case. A 7-year-old renal allograft recipient presented with severe anemia due to parvovirus infection after RTX treatment. The patient had focal segmental glomerulosclerosis and had received cadaveric kidney transplantation 6 months previously. She was treated with high-dose steroid for acute rejection and RTX for Epstein Barr Virus infection 3 months previously. At presentation, her hemoglobin level was 5.4 g/dL and leukocyte and platelet counts were normal. She had microcytic normochromic anemia and high viral load of parvovirus B19(70,578 copies/mL). Intravenous immunoglobulin ($200mg/kg{\cdot}d$) treatment controlled the progression of anemia and parvovirus infection. De novo parvovirus infection during the B lymphocyte-depletion period may have precipitated the severe anemia in this case. Close monitoring of infection is required after RTX therapy.

Successful Treatment with Rituximab and Immunoadsorption for an Auto-Antibody Induced Bile Salt Export Pump Deficiency in a Liver Transplanted Patient

  • Quintero, Jesus;Juamperez, Javier;Gonzales, Emmanuel;Julio, Ecaterina;Mercadal-Hally, Maria;Collado-Hilly, Mauricette;Marin-Sanchez, Ana;Charco, Ramon
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.23 no.2
    • /
    • pp.174-179
    • /
    • 2020
  • We present an 8 years old girl who was diagnosed at 6 months of age of Progressive Familial Intrahepatic Cholestasis type 2. Although liver transplantation (LT) was classically considered curative for these patients, cholestasis recurrence with normal gamma-glutamyl transpeptidase (GGT), mediated by anti-bile salt export pump (BSEP) antibodies after LT (auto-antibody Induced BSEP Deficiency, AIBD) has been recently reported. Our patient underwent LT at 14 months. During her evolution, patient presented three episodes of acute rejection. Seven years after the LT, the patient presented pruritus with cholestasis and elevation of liver enzymes with persistent normal GGT. Liver biopsy showed intrahepatic cholestasis and giant-cell transformation with very low BSEP activity. Auto-antibodies against BSEP were detected therefore an AIBD was diagnosed. She was treated with Rituximab and immunoadsorption with resolution of the AIBD. As a complication of the treatment she developed a pneumocystis infection successfully treated with corticoids, cotrimoxazol and anidulafungin.

Total lymphoid irradiation based conditioning for hematopoietic stem cell transplantation in severe aplastic anemia

  • Lee, Yun-Hee;Kim, Ji-Yoon;Choi, Byung-Ock;Ryu, Mi-Ryeong;Chung, Su-Mi
    • Radiation Oncology Journal
    • /
    • v.30 no.4
    • /
    • pp.165-172
    • /
    • 2012
  • Purpose: To retrospectively evaluate the outcome and toxicity of total lymphoid irradiation (TLI) based conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in severe aplastic anemia (SAA) patients who experienced an engraftment failure from prior HSCT or were heavily transfused. Materials and Methods: Between 1995 and 2006, 20 SAA patients received TLI for conditioning of HSCT. All patients were multi-transfused or had long duration of disease. Fifteen (75%) patients had graft failure from prior HSCT. In 18 (90%) patients, the donors were human leukocyte antigen identical siblings. The stem cell source was the peripheral blood stem cell in 15 (75%) patients. The conditioning regimen was composed of antithymocyte globulin plus TLI with a median dose of 750 cGy in 1 fraction. The graft-versus-host disease (GVHD) prophylaxis used cyclosporine with methotrexate. Results: With a median follow-up of 10.8 years, graft failures developed in 6 patients. Among them, 3 patients received their third HSCT to be engrafted finally. The Kaplan-Meier overall survival rate was 85.0% and 83.1% at 5 and 10 years, respectively. The incidence of acute and chronic GVHD was 20% and 20%, respectively. None of the patients have developed a malignancy after HSCT. Conclusion: In our study, TLI based conditioning in allogeneic HSCT was feasible with acceptable rates of GVHD in SAA patients who experienced graft failure from prior HSCT or was at a high risk of graft rejection. We achieved relatively better results of engraftment and survival with a long term follow-up.

The Effect of Parenting Efficacy, Parenting Behavior and Parenting Stress on Preschool Children's Problematic Behavior in Korea and China (한국과 중국 어머니의 양육효능감, 양육행동, 양육스트레스가 유아의 문제행동에 미치는 영향)

  • Jin, Yan Chun;Jang, Young Ae
    • The Korean Journal of Community Living Science
    • /
    • v.24 no.1
    • /
    • pp.99-118
    • /
    • 2013
  • The purpose of this study was to examine the effects of parenting efficacy, parenting behavior, and parenting stress on children's problematic behavior in Korea and China. The subjects were 292 children and their mothers who are caring for their 3-5 years old children in Korea and China. Data was collected using a parenting efficacy index, parenting behavior index, parenting stress index and child behavior check list. The data were statistically analyzed using t-test, one-way ANOVA (Scheff$\acute{e}$ test), correlation analysis and multiple regression analysis. The study showed that there were no significant differences in parenting efficacy, parenting behavior, parenting stress and children's problematic behavior in Korea and China. There were some significant differences in children's problematic behavior according to the socio-demographic variables, that is the gender of the child, the mother's education, the father's education, in Korea and China. Correlation analysis indicated that the parenting efficacy, parenting behavior, parenting stress and children's problematic behavior in Korea and China had significant correlations in some sub-variables. It was also found that the gender of the child, the mother's education, the father's education, the frustration and uneasiness of the parents, the control behavior, and the stress of parent-child dysfunctional interaction, were all significant predictors of the preschool children's problematic behavior in Korea, and the mother's education, the family income, the affection behavior, the rejection behavior, and the control behavior, were all significant predictors of the preschool children's problematic behavior in China.

Heart Transplantation in Patients with Superior Vena Cava to Pulmonary Artery Anastomosis: A Single-Institution Experience

  • Jeon, Bo Bae;Park, Chun Soo;Yun, Tae-Jin
    • Journal of Chest Surgery
    • /
    • v.51 no.3
    • /
    • pp.167-171
    • /
    • 2018
  • Background: Heart transplantation (HTx) can be a life-saving procedure for patients in whom single ventricle palliation or one-and-a-half ($1\text\tiny{1/2}$) ventricle repair has failed. However, the presence of a previous bidirectional cavopulmonary shunt (BCS) necessitates extensive pulmonary artery angioplasty, which may lead to worse outcomes. We sought to assess the post-HTx outcomes in patients with a previous BCS, and to assess the technical feasibility of leaving the BCS in place during HTx. Methods: From 1992 to 2017, 11 HTx were performed in patients failing from Fontan (n=7), BCS (n=3), or $1\text\tiny{1/2}$ ventricle (n=1) physiology at Asan Medical Center. The median age at HTx was 12.0 years (range, 3-24 years). Three patients (27.3%) underwent HTx without taking down the previous BCS. Results: No early mortality was observed. One patient died of acute rejection 3.5 years after HTx. The overall survival rate was 91% at 2 years. In the 3 patients without BCS take-down, the median anastomosis time was 65 minutes (range, 54-68 minutes), which was shorter than in the patients with BCS take-down (93 minutes; range, 62-128 minutes), while the postoperative central venous pressure (CVP) was comparable to the preoperative CVP. Conclusion: Transplantation can be successfully performed in patients with end-stage congenital heart disease after single ventricle palliation or $1\text\tiny{1/2}$ ventricle repair. Leaving the BCS in place during HTx may simplify the operative procedure without causing significant adverse outcomes.

Heart Retransplantation in a Patient with Cardiac Allograft Vasculopathy after Primary Heart Transplantation? - A case report - (일차 심장 이식 후 발생한 Cardiac Allograft Vasculopathy의 치료로서의 심장 재이식 - 1예 보고 -)

  • Shim, Man-Shik;Sung, Kiick;Kim, Wook Sung;Lee, Young-Tak;Jeon, Eun-Seok;Park, Pyo-Won
    • Journal of Chest Surgery
    • /
    • v.43 no.1
    • /
    • pp.73-76
    • /
    • 2010
  • Cardiac allograft vasculopathy (CAV) is a major factor that limits the long-term survival after cardiac transplantation. Because the main feature of CAV is a diffuse stenosis that predominantly develops in the distal arteries, reperfusion therapy has shown poor outcomes. The results of cardiac retransplantation for CAV are better than that for acute resection and the survival is identical to that of patients who undergo primary transplantation. We describe a case of performing cardiac retransplantation in a 28 year-old male patient with refractory CAV and who underwent primary transplantation due to dilated cardiomyopathy 8 years previously.

The Effect of Donor Antigen-pulsed Dendritic Cells on Survival of Skin Allograft in a Rat Model (흰쥐 모델에서 공여항원에 감작된 수지상세포가 피부동종이식의 생착에 미치는 영향)

  • Eun, Seok Chan;Kim, Byung Jun;Kim, Jin Hee;Heo, Chan Yeong;Baek, Rong Min;Chang, Hak;Minn, Kyung Won
    • Archives of Plastic Surgery
    • /
    • v.35 no.4
    • /
    • pp.367-372
    • /
    • 2008
  • Purpose: Prevention of acute rejection in skin allografts without continuous immunosuppression lacks reports in worldwide literature. Needs for chronic immunosuppression preclude the use of tissue allograft as a routine surgical reconstructive option. Recently dendritic cells(DC) gained considerable attention as antigen presenting cells that are also capable of immunologic tolerance induction. This study assesses the effects of alloantigen-pulsed dendritic cells in induction of survival increase in a rat skin allograft model. Methods: Recipient-derived dendritic cells were harvested from rat whole blood and cultured with GM-CSF(200 ng/mL) and IL-4(8 ng/mL) for 2 weeks. Then donor-specific alloantigen pulsed dendritic cells were reinjected into tail vein before skin graft. The rat dorsal skin allografts were transplanted in 5 subgroups. Groups: I) untreated, II) anti-lymphocyte serum(ALS, 0.5 mL), III) FK-506(2 mg/kg), IV) DCp, VI) DCp and FK-506. Graft appearance challenges were assessed postoperatively. Results: The group V(DC and FK-506 treated) showed longest graft survival rate(23.5 days) than other groups; untreated(5.8 days), ALS(7.2 days), FK-506 (17.5 days), DCp(12.2 days). Conclusion: Donor antigen pulsed host dendritic cell combined with short-term immunosuppression prolong skin allograft survival and has potential therapeutic application for induction of donor antigen specific tolerance.

A Case Report of Heart Transplantation Bridged by Bi-ventricular Assist Device in a Pediatric Patient of Prerenal Type ARF (소아환자에서 양심실 순환보조를 중개로 한 후 발생한 급성신부전 환자에서의 심장 이식수술 치험 1예)

  • Ra, Yong-Joon;Koak, Jae-Gun;Kim, Jin-Hyun;Oh, Se-Jin;Lee, Jae-Hang;Kim, Woong-Han
    • Journal of Chest Surgery
    • /
    • v.39 no.11 s.268
    • /
    • pp.854-857
    • /
    • 2006
  • The patient was an eight-year-old female. She was diagnosed as dilated cardiomyopathy. She was supported with bi-ventricular assist because of heart failure for 15 days. After 7 days, she was suffered from prerenal type ARF and support with continuous veno-veno hemodyalisis(CVVHD). And then heart transplantation was performed, heart donor's blood type was A. Immune suppressants were used after due consideration for renal toxicity. ARF was resolved on post operative $14^{th}$ day. She was discharged on post operative $52^{nd}$ day without any specific post operative complication. She has been followed up without any immune rejection reaction upto 14 months.

Understanding of Posttraumatic Embitterment Disorder (PTED) (외상후 울분장애의 이해)

  • Ko, Han-Suk;Han, Chang-Su;Chae, Jeong-Ho
    • Anxiety and mood
    • /
    • v.10 no.1
    • /
    • pp.3-10
    • /
    • 2014
  • Reactive disorder is a group of diagnosis with a definitely known etiology and whose etiological factor is essential to the diagnosis. In DSM system, such reactive disorders are listed as adjustment disorder, acute stress disorder, brief psychotic disorder with marked stressor and posttraumatic stress disorder (PTSD). However, a growing number of individuals is suffering from a prolonged feeling of embitterment after exceptional negative life events and this condition could be diagnosed neither PTSD nor adjustment disorder nor depressive disorder in the context of DSM-IV diagnostic system. This clinical condition can be described as 'posttraumatic embitterment disorder' (PTED). PTED is a reactive disorder triggered by exceptional, though normal negative life events such as conflict in the workplace, unemployment, death of a relative, divorce, severe illness, or experience of loss or separation. The common feature of such events is that they are experienced as unjust, as a personal insult, accompanied by psychological violation of basic beliefs and values. The central psychopathological response pattern in PTED is a prolonged feeling of embitterment. In particular, the core emotion of embitterment can lead to the rejection of treatment. Therefore, "wisdom therapy" as a new treatment approach specifically designed for PTED has been developed. It is assumed that many patients suffering from PTED are often misunderstood and misdiagnosed. This review would help to introduce PTED into the clinical field in psychiatry.